Dramatic improvement of refractory anemia caused by mechanical hemolysis in a patient with hypertrophic obstructive cardiomyopathy using dual-chamber pacing.

A 59-year-old woman with hypertrophic obstructive cardiomyopathy was admitted to our institution with worsening heart failure. She developed mechanical intracardiac hemolysis due to left ventricular outflow tract (LVOT) obstruction. Despite surgical myectomy, the LVOT pressure gradient (PG) remained high and hemolytic anemia recurred. A dual-chamber implantable cardioverter defibrillator was then implanted, which decreased the LVOT-PG and improved hemolysis.